RUNNING OUT OF TIME - Condom breakage during sex with a Prostitute

Question

Dr. Bob,

The VA does not do PEP for situations like this and I need to know if PEP is warranted in a situation like this. I am at the 29th hour right now and am getting really nervous.

Briefly - I was having sex at a Massage parlor in Philadelphia and the condom broke. I didn't realize what had happened for a good 3-5 minutes although since it felt alot better I should have known.

The status is unknown for the girl. I don't have any opening on my penis that I can see. I was treated for everything else by the ER last night except for possible HIV.

I have tried very hard to do a risk assessment online but haven't been able to find one.

I will gladly help you out anyway I can if you can just let me know what you think about the PEP necessity.

Thanks

Answer

Hello,

I would agree with the VA decision not to recommend PEP for the type of potential exposure you had. (Even though PEP may be prescribed by some physicians for similar situations.)

The estimated per-act statistical risk of acquiring HIV from unprotected insertive penile-vaginal sex with a partner confirmed to be HIV infected is 5 per 10,000 exposures. Your estimated statistical risk would be less, as we do not know the HIV status of your hooker-masseuse.

I would recommend you get an HIV-antibody test at the three-month mark. In addition, I'd also advise you review proper condom technique, as they very rarely fail (break) when used properly. You can read about proper condom techniques in the archives of this forum.

Good luck. Remember, the odds are very much in your favor that you did not contract HIV from your massage with benefits.

Dr. Bob